Provider Demographics
NPI:1164906277
Name:PIVOVAR, PAIGE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:PIVOVAR
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:KOBLITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7021 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1430
Mailing Address - Country:US
Mailing Address - Phone:620-825-6123
Mailing Address - Fax:
Practice Address - Street 1:1220 N 8TH ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5108
Practice Address - Country:US
Practice Address - Phone:162-082-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-04394OtherKANSAS BOARD OF HEALING ARTS